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The association between adversity and hair cortisol levels in humans: A meta-analysis
Open accessAbstract
Adverse life events are associated with a constellation of negative health outcomes. Theory and research suggest that the hypothalamic-pituitary-adrenal (HPA) axis acts as one mechanism connecting adverse experiences with negative health outcomes. However, this relation is complicated by the potential for adversity to be associated with both hyperactivity and hypoactivity of the HPA axis, as assessed in both animal and human studies. Over the past decade, methodological advances have enabled the sampling of cortisol stored in hair, which provides a marker of HPA axis activity over a several-month period. The present meta-analysis included 28 studies to assess the strength and direction of the relation between adverse experiences and hair cortisol levels. Analyses were conducted using multilevel modeling (MLM) to quantify the magnitude of effects and mixture modeling to identify distinct subgroups of studies. Results of MLM analyses indicated that the overall effect size was small but significant d = 0.213, 95% CI [0.034, 0.397]. There was also significant between-study variance (τ = 0.155, 95% CI [0.065, 0.367]). Mixture modeling to identify distinct classes of studies based on effect size and direction resulted in a 2-class model: The first class included four studies with an overall negative and moderate effect size (d = -0.478, 95% CI [-0.639, -0.318]), and the second class included the remaining 24 studies with an overall positive and significant, albeit small, effect size (d = 0.141, 95% CI [0.084, 0.199]). Moderator analyses indicated that the strength and direction of the association between adversity and hair cortisol were moderated by features of the adversity exposure (e.g., type of adversity, timing of adversity), characteristics of the samples (e.g., clinical status, racial distribution), and features of the publication (e.g., publication type, geographic region of study). The findings refine our understanding of the long-term impact of adversity on dysregulation of the HPA axis, particularly as reflected in hair cortisol measures.
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“Inflammatory factors such as cortisol and C-reactive protein (CRP) are associated with breast cancer progression18 and psychological problems.19”
From The Effect of Mindfulness-Based Stress Reduction Group Counseling on Psychological and Inflammatory Responses of the Women With Breast Cancer (2020) · cites this paper as [19]
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Cites
Nylund, K. L., Asparouhov, T., & Muthén, B. O. (2007) · Structural Equation Modeling: A Multidisciplinary Journal · doi:10.1080/10705510701575396 · Cited by 11,415
Wasserman, S. S., Hedges, L. V., & Olkin, I. (1988) · Journal of Educational Statistics · doi:10.2307/1164953 · Cited by 10,377
Cohen, J. (1992) · Psychological Bulletin · doi:10.1037//0033-2909.112.1.155 · Cited by 8,771
Sapolsky, R. M., Romero, L. M., & Munck, A. U. (2000) · Endocrine Reviews · doi:10.1210/edrv.21.1.0389 · Cited by 7,541
Sapolsky, R. M. (2000) · Endocrine Reviews · doi:10.1210/er.21.1.55 · Cited by 7,533
Protective and Damaging Effects of Stress Mediators
McEwen, B. S. (1998) · New England Journal of Medicine · doi:10.1056/nejm199801153380307 · Cited by 6,733 · cited 2×
“Deleterious health effects are caused by dysregulation of the HPA axis, which can include intense or chronic over-activation or under-activation (Chrousos, 2009), known as allostatic overload (McEwen, 1998).”
BackgroundDickerson, S. S., & Kemeny, M. E. (2004) · Psychological Bulletin · doi:10.1037/0033-2909.130.3.355 · Cited by 5,881
Physiology and neurobiology of stress and adaptation: central role of the brain
McEwen, B. S. (2007) · Physiological Reviews · doi:10.1152/physrev.00041.2006 · Cited by 5,429 · cited 2×
“For example, heightened activity of the amygdala results in increased stimulation of the paraventricular nucleus of the hypothalamus (McEwen, 2007), contributing to greater HPA activity.”
BackgroundStatistical Methods for Meta-Analysis.
Freeman, P. R., Hedges, L. V., & Olkin, I. (1986) · Biometrics · doi:10.2307/2531069 · Cited by 4,839
Stress and disorders of the stress system
Chrousos, G. P. (2009) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2009.106 · Cited by 3,215
Research works printed but not linked: 3
- Guilliams, 2010, Chronic stress and the HPA axis, The standard, 9, 1
- *Keenan-Devlin, 2015, The weight of structural violence:syndemic stress and obesity among black urban youth in the US, Diss. Abstr. Int.
- Muthén, 2013, BSEM measurement invariance analysis, Mplus Web Notes, 17, 1
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“In humans, a meta-analysis showed adverse life events are associated with a small but significant increase in cortisol stored in hair as a marker of HPA axis activity over several months [37].”
BackgroundCardiovascular Disease and Hair Cortisol: a Novel Biomarker of Chronic Stress
Iob, E., & Steptoe, A. (2019) · Current Cardiology Reports · doi:10.1007/s11886-019-1208-7 · Cited by 229
The complex neurobiology of resilient functioning after childhood maltreatment
Ioannidis, K., Askelund, A. D., Kievit, R., & van Harmelen, A. (2020) · BMC Medicine · doi:10.1186/s12916-020-1490-7 · Cited by 175
“It has been suggested that the associations of cortisol with CM differ for patients with and without psychopathology [73].”
BackgroundStress and Psychiatric Disorders: The Role of Mitochondria
Daniels, T. E., Olsen, E. M., & Tyrka, A. R. (2020) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-082719-104030 · Cited by 157
“Differential patterns of dysregulation appear to be mediated in part by the type of stressor, reported age at the time of stress, and chronicity (Khoury et al. 2019).”
BackgroundThe social ecology of childhood and early life adversity
Lopez, M., Ruiz, M. O., Rovnaghi, C. R., Tam, G. K.-Y., Hiscox, J., Gotlib, I. H., Barr, D. A., Carrión, V. G., & Anand, K. J. S. (2021) · Pediatric Research · doi:10.1038/s41390-020-01264-x · Cited by 200
Hakamata, Y., Suzuki, Y., Kobashikawa, H., & Hori, H. (2022) · Frontiers in Neuroendocrinology · doi:10.1016/j.yfrne.2022.100994 · Cited by 159
“The other studies however showed no significant association of ACEs with cortisol levels at the time of waking up (Bernard et al., 2017), and with hair cortisol levels (Khoury et al., 2019).”
InfluentialDempster, K. S., O’Leary, D. D., MacNeil, A. J., Hodges, G. J., & Wade, T. J. (2020) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2020.12.018 · Cited by 138
Iob, E., Lacey, R. E., & Steptoe, A. (2019) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2019.12.019 · Cited by 95
“the recent meta-analysis of ACEs and hair cortisol included 28 studies with a total sample of only 3,397 participants (Khoury et al., 2019); 3) a more robust assessment of pro-inflammatory state and long-term HPA-axis activity owing to the use of repeated measures of CRP and quantification of cortisol in human hair; 4…”
InfluentialNature connectedness boosts the bright side of emotion regulation, which in turn reduces stress
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Mirmahmoodi, M., Mangalian, P., Ahmadi, A., & Dehghan, M. (2020) · Integrative Cancer Therapies · doi:10.1177/1534735420946819 · Cited by 67
Rubika, A., Luoto, S., Krama, T., Trakimas, G., Rantala, M. J., Moore, F. R., Skrinda, I., Elferts, D., Krams, R., Contreras-Garduño, J. A., et al. (2020) · Scientific Reports · doi:10.1038/s41598-020-68217-6 · Cited by 63
Iob, E., Baldwin, J. R., Plomin, R. J., & Steptoe, A. (2021) · Translational Psychiatry · doi:10.1038/s41398-021-01538-w · Cited by 53
“Similar inconsistencies have also been documented in studies measuring cortisol in hair, which provides an indication of average cortisol exposure over several weeks [20, 21].”
ResultSchalinski, I., Teicher, M. H., & Rockstroh, B. S. (2019) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2019.06.007 · Cited by 52
Rinne, G. R., Hartstein, J., Guardino, C. M., & Schetter, C. D. (2023) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2023.106115 · Cited by 53
“For example, in non-pregnant samples, the associations between stress and both cortisol reactivity and hair cortisol vary depending on the type and timing of the stress and adversity (Dickerson and Kemeny, 2004; Khoury et al., 2019).”
Hair cortisol levels in posttraumatic stress disorder and metabolic syndrome
van den Heuvel, L. L., Tobias Stalder, A., du Plessis, S., Suliman, S., Kirschbaum, C., & Seedat, S. (2020) · Stress · doi:10.1080/10253890.2020.1724949 · Cited by 47
Intimate partner violence and hair cortisol concentration: A biomarker for HPA axis function
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Shapero, B. G., Curley, E. E., Black, C. L., & Alloy, L. B. (2019) · Depression and Anxiety · doi:10.1002/da.22957 · Cited by 49
“…that is less susceptible to daily factors that influence other methods of cortisol assessment (Dettenborn et al., 2012), but it also captures HPA axis functioning during circumscribed time periods (Khoury et al., 2019; Russell et al., 2012; Stalder & Kirschbaum, 2012; Staufenbiel et al., 2013).”
Backgroundvan der Laan, J. E., Vinke, C. M., & Arndt, S. S. (2022) · Scientific Reports · doi:10.1038/s41598-022-09140-w · Cited by 47
Smeeth, D. M., McEwen, F. S., Popham, C. M., Karam, E. G., Fayyad, J. A., Saab, D., Rieder, M. J., Elzagallaai, A. A., Uum, S. H. M. V., & Pluess, M. (2022) · Molecular Psychiatry · doi:10.1038/s41380-022-01859-2 · Cited by 54
“This measure of average HPA axis activity has shown that adversity is frequently associated with altered hair hormone concentration (HCC) levels in adults, but this is dependent on the type and timing of adversity as well as the current psychopathological state of the study population [15, 16].”
BackgroundOuellet‐Morin, I., Cantave, C. Y., Paquin, S., Geoffroy, M., Brendgen, M. R., Vitaro, F., Tremblay, R. E., Boivin, M., LUPIEN, S. J., & Côté, S. M. (2020) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13228 · Cited by 46
The Pathways between Cortisol-Related Regulation Genes and PTSD Psychotherapy
Castro-Vale, I., & Carvalho, D. M. (2020) · Healthcare · doi:10.3390/healthcare8040376 · Cited by 39
“Some of these risk factors also influence the HPA axis function, examples being childhood adversity, parental PTSD, or the occurrence of prior TE or PTSD [9,28].”
BackgroundStetler, C., & Guinn, V. (2020) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2020.104584 · Cited by 42
“Although a growing body of work supports an association between stressful events and HCC (Khoury et al., 2019), the association between perceived stress and HCC has been less reliable.”
BackgroundMatte-Landry, A., Bolduc, M.-È. G., Tanguay-Garneau, L., Collin‐Vézina, D., & Ouellet‐Morin, I. (2022) · Trauma Violence & Abuse · doi:10.1177/15248380221111484 · Cited by 47
Hair cortisol concentrations are associated with hippocampal subregional volumes in children
Keresztes, A., Raffington, L., Bender, A. R., Bögl, K., Heim, C. C., & Shing, Y. L. (2020) · Scientific Reports · doi:10.1038/s41598-020-61131-x · Cited by 34
Stephens, J. E., Kessler, C. L., Buß, C., Miller, G. E., Grobman, W. A., Keenan‐Devlin, L. S., Borders, A. E. B., & Adam, E. K. (2020) · Developmental Psychobiology · doi:10.1002/dev.22000 · Cited by 37
“A recent metaanalysis found a small but significant relationship between greater life adversity and increased hair cortisol levels (Khoury et al., 2019).”
BackgroundCortisol, Stress, and Disease—Bidirectional Associations; Role for Corticosteroid-Binding Globulin?
Lee, J. H., Meyer, E. J., Nenke, M. A., Lightman, S. L., & Torpy, D. J. (2024) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgae412 · Cited by 38
Pittner, K., Buisman, R. S. M., van den Berg, L. J. M., Block, L. C.-D., Tollenaar, M. S., Bakermans‐Kranenburg, M. J., van IJzendoorn, M. H., Elzinga, B. M., & Alink, L. R. A. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00387 · Cited by 33
“This is also in line with the majority of research on maltreatment and hair cortisol which suggest elevated cortisol secretion (38).”
BackgroundResultInfluentialDoom, J. R., Peckins, M. K., Hein, T. C., Dotterer, H. L., Mitchell, C., Lopez‐Duran, N. L., Jeanne Brooks-gunn, B., McLanahan, S., Hyde, L. W., Abelson, J. L., et al. (2020) · Development and Psychopathology · doi:10.1017/s0954579420000954 · Cited by 35
“Timing of adversity is a significant moderator of hair cortisol concentration, with adult trauma showing stronger positive associations with overall cortisol output than childhood trauma (Khoury et al., 2019).”
BackgroundResultInfluentialvan der Valk, E. S., Abawi, O., Mohseni, M., Abdelmoumen, A., Wester, V. L., van der Voorn, B., Iyer, A. M., van den Akker, E. L. T., Hoeks, S. E., van den Berg, S. A. A., et al. (2021) · Obesity Reviews · doi:10.1111/obr.13376 · Cited by 33
“For example, a recent meta-analysis demonstrated that adversity also relates to long-term GC levels, although this relation is complex and depends on the type and timing of adversity and on the studied population.(154) Adversity and stressful conditions can have similar complex relations to obesity.”
Backgroundde Leeuw, M. J., Oppewal, A., Elbers, R. G., Knulst, M. W. E. J., van Maurik, M. C., van Bruggen, M. C., Hilgenkamp, T. I. M., Bindels, P., & Festen, D. A. M. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-053499 · Cited by 38
Niu, L., Gao, Q., Xie, M., Yip, T., Gunnar, M. R., Wang, W., Xu, Q., Zhang, Y., & Lin, D. (2025) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2025.106124 · Cited by 40
Early childhood stress responses to psychosocial stressors: The state of the science
Bates, R. A., Militello, L. K., Barker, E., Villasanti, H. G., & Schmeer, K. K. (2022) · Developmental Psychobiology · doi:10.1002/dev.22320 · Cited by 29
“Both heightened and blunted stress responsesmay be significant indicators of stress responses (Ford et al., 2019; Khoury et al., 2019; Miller et al., 2007; Xu et al., 2019) and highlight potential physiological disruptions during sensitive periods of development.”
BackgroundBuchmüller, T., Lembcke, H., Busch, J., Kumsta, R., Wolf, O. T., & Leyendecker, B. (2020) · Stress · doi:10.1080/10253890.2020.1737008 · Cited by 28
“Refugees offer a possibility to study the physiological effects of chronic adversities during adulthood otherwise often investigated in childhood (Khoury et al., 2019).”
BackgroundEpigenetic Mechanisms Activated by Childhood Adversity
Krause, B. J., Artigas, R., Sciolla, A., & Hamilton, J. (2020) · Epigenomics · doi:10.2217/epi-2020-0042 · Cited by 29
Green, C., Stolicyn, A., Harris, M. A., Shen, X., Romaniuk, L., Barbu, M. C., Hawkins, E. L., Wardlaw, J. M., Steele, J. D., Waiter, G. D., et al. (2021) · Translational Psychiatry · doi:10.1038/s41398-021-01644-9 · Cited by 28
Rosenfield, P., Jiang, D., & Pauselli, L. (2021) · Schizophrenia Research · doi:10.1016/j.schres.2021.06.005 · Cited by 33
Taylor, K. S., Steptoe, A., & Iob, E. (2022) · Molecular Psychiatry · doi:10.1038/s41380-022-01805-2 · Cited by 27
“This suggests that both the type and timing of adversity are important in understanding the relationship between ACEs and adverse biological outcomes [20].”
BackgroundMethodLyons‐Ruth, K., Li, F. H., Khoury, J. E., Ahtam, B., Sisitsky, M. D., Ou, Y., Enlow, M. B., & Grant, P. E. (2023) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-023-01041-4 · Cited by 31
“Both blunted (downregulated) and elevated cortisol levels have been associated with childhood maltreatment (e.g., Bernard et al., 2017; Khoury et al., 2019).”
BackgroundSelf-citationDemakakos, P., Demakakou, E. L., & Mishra, G. D. (2020) · Human Reproduction · doi:10.1093/humrep/deaa113 · Cited by 29
“, 2009) and subsequent dysregulation of the neuroendocrine and immune systems (Hunter et al., 2011; Slopen et al., 2012; Chiang et al., 2015; Elwenspoek et al., 2017; Khoury et al., 2019), we also hypothesized that ACE could be directly related with miscarriage risk via biological pathways.”
BackgroundAssociations between social adversity and young children’s hair cortisol: A systematic review
Bryson, H., Price, A. M. H., Goldfeld, S. R., & Mensah, F. K. (2021) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2021.105176 · Cited by 26
Ford, J. L., Browning, C. R., Boch, S. J., Kertes, D. A., Tarrence, J. A., Way, B. M., & Schmeer, K. K. (2021) · Nursing Research · doi:10.1097/nnr.0000000000000527 · Cited by 26
Behnke, A., Gumpp, A. M., Krumbholz, A., Bach, A. M., Schelling, G., Kolassa, I., & Rojas, R. (2021) · Comprehensive Psychoneuroendocrinology · doi:10.1016/j.cpnec.2021.100068 · Cited by 24
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“However, whether cortisol has utility as an unbiased biological signature of previous adversity or is predictive of mental health problems is not yet clear [6].”
BackgroundSchindler‐Gmelch, L., Capito, K., Steudte‐Schmiedgen, S., Kirschbaum, C., & Berking, M. (2023) · Current Neuropharmacology · doi:10.2174/1570159x21666230807112425 · Cited by 25
Behnke, A., Karabatsiakis, A., Krumbholz, A., Karrasch, S., Schelling, G., Kolassa, I., & Rojas, R. (2020) · Scientific Reports · doi:10.1038/s41598-020-79859-x · Cited by 26
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“Although a meta-analysis combining data from pregnant and non-pregnant people indicated a small but significant positive association between life adversity and HCC [21], few studies have examined recent adverse experiences in relation to HCC during pregnancy.”
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“Moreover, it has also been demonstrated to affected children’s neuroendocrine stress response system up into adulthood 41–43 .”
BackgroundKhoury, J. E., Enlow, M. B., Patwa, M. C., & Lyons‐Ruth, K. (2020) · Developmental Psychobiology · doi:10.1002/dev.21950 · Cited by 23
Self-citationFeeney, J. C., & Kenny, R. A. (2022) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2022.105847 · Cited by 20
Bertele, S., Heitland, I., Fraccarollo, D., Stapel, B., Bauersachs, J. K., Westhoff‐Bleck, M., & Kahl, K. G. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.1002143 · Cited by 23
Broeks, C. W., Molenaar, N. M., Brouwer, M. E., van den Akker, E. L. T., van Rossum, E. F. C., Van, R., van den Berg, S. A. A., Hillegers, M. H. J., Hoogendijk, W. J. G., Burger, H., et al. (2023) · Comprehensive Psychoneuroendocrinology · doi:10.1016/j.cpnec.2023.100167 · Cited by 20
“A detailed exploration yielded that lower HCC was more often associated with maltreatment beginning in childhood [22].”
BackgroundOresta, S., Vinkers, C. H., van Rossum, E. F. C., Penninx, B. W. J. H., & Nawijn, L. (2021) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2021.105150 · Cited by 22
“(2019) and the current study were weak, and markedly smaller relative to the earlier reported meta-analytic observations (Khoury et al., 2019; Stalder et al, 2017).”
BackgroundResultInfluentialThe Glucocorticoid Receptor Gene (NR3C1) 9β SNP Is Associated with Posttraumatic Stress Disorder
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“HCC have also been influenced by time since trauma, type of trauma, childhood adversities, and hair manipulations [9,10].”
BackgroundOuellet‐Morin, I., Cantave, C. Y., LUPIEN, S. J., Geoffroy, M., Brendgen, M. R., Vitaro, F., Tremblay, R. E., Boivin, M., & Côté, S. M. (2021) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2021.105153 · Cited by 22
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“Studies that assess high prenatal stress due to exposure to disasters (e.g., ice storm; King and Laplante, 2005) or severe trauma (e.g., 9/11; Yehuda et al., 2005), can be seen as natural experiments in which all participants experience the same independent stressor (King et al., 2012).”
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Wenzel, E., Frye, R., Roberson‐Nay, R., & Payne, J. L. (2025) · Trends in Neurosciences · doi:10.1016/j.tins.2025.05.005 · Cited by 18
Penner, F., Khoury, J. E., Enlow, M. B., & Lyons‐Ruth, K. (2023) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2023.106107 · Cited by 19
Self-citationPauli‐Pott, U., Skoluda, N., Nater, U. M., Becker, K., Derz, F., Kaspar, E., Kasperzack, D., Kehm, K., Kött, M., Mann, C., et al. (2023) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-023-02180-1 · Cited by 19
“As these conditions have sometimes been found to be associated with HCC in the general population [20, 32] it is possible that low HCC in ADHD indicates exposure to environmental adversity.”
BackgroundIkram, N., Frost, A., LeMasters, K. H., Hagaman, A. K., Baranov, V., Gallis, J. A., Sikander, S., Scherer, E. M., & Maselko, J. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-052280 · Cited by 24
Chong, L. S., Gordis, E. B., Hunter, L., Amoh, J., Strully, K. W., Appleton, A. A., & Tracy, M. (2022) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2022.105898 · Cited by 21
Bürgin, D., Clemens, V., Varghese, N., Eckert, A., Huber, M., Bruttin, E., Boonmann, C., Unternährer, E., O'Donovan, A., & Schmid, M. (2022) · Brain, Behavior, & Immunity - Health · doi:10.1016/j.bbih.2022.100524 · Cited by 14
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Correa‐Burrows, P., Burrows, R. A., Cecilia Albala, B., Court, F. A., Salech, F., Sanhueza, G. E., & González-Billault, C. E. (2022) · BMC Geriatrics · doi:10.1186/s12877-022-03032-4 · Cited by 16
Steudte‐Schmiedgen, S., Schälicke, S., Bergunde, L., Karl, M., Weise, V., Junge‐Hoffmeister, J., Schumacher, S., von Soest, T., Weidner, K., Kirschbaum, C., et al. (2022) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2022.105973 · Cited by 15
Hair cortisol levels in women with medically unexplained symptoms
Fischer, S., Skoluda, N., Ali, N., Nater, U. M., & Mewes, R. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2021.12.044 · Cited by 14
Influences of adversity across the lifespan on respiratory sinus arrhythmia during pregnancy
Kaliush, P. R., Terrell, S., Vlisides‐Henry, R. D., Lin, B., Neff, D., Shakiba, N., Conradt, E. D., & Crowell, S. E. (2021) · Developmental Psychobiology · doi:10.1002/dev.22132 · Cited by 14
“…stress biology, including inflammatory processes (McCormack et al., 2021), hypothalamic-pituitary-adrenal axis functioning (Epstein et al., 2019; Khoury et al., 2019; Morrison et al., 2017; Stephens et al., 2020; Swales et al., 2018; Thomas et al., 2018), and placental corticotropin-releasing…”
BackgroundArefian, M., & Asgari, K. (2025) · European Journal of Oncology Nursing · doi:10.1016/j.ejon.2025.102881 · Cited by 13
Achenbach, J., Volkmann, L., Tran, A.-T., Jäger, B., Rhein, M., Glahn, A., Bernateck, M., & Karst, M. (2022) · Disease Markers · doi:10.1155/2022/7958375 · Cited by 13
“In contrast, chronic stress has also been found to impair cortisol secretion and HPA-axis (hypothalamicpituitary-adrenal axis) function in general as well as in patients with fibromyalgia leading to decreased resilience [15, 16].”
BackgroundMaternal separation in childhood and hair cortisol concentrations in late adulthood
Bevan, K., & Meena Kumari, B. (2021) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2021.105253 · Cited by 14
Whitney, S., Bedard, C., Mielke, J. G., Browne, D. T., & Ferro, M. A. (2022) · Comprehensive Psychoneuroendocrinology · doi:10.1016/j.cpnec.2022.100155 · Cited by 12
Adverse childhood experiences and diurnal cortisol patterns in older people in England
Demakakos, P., & Steptoe, A. (2022) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2022.105798 · Cited by 16
Marsland, A. L., Jones, E., Reed, R. G., Walsh, C. P., Natale, B. N., Lindsay, E. K., & Ewing, L. J. (2024) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2024.107039 · Cited by 18
The predictive role of hair cortisol concentrations for treatment outcome in PTSD inpatients
Hummel, K. V., Schellong, J., Trautmann, S., Kummer, S., Hürrig, S., Klose, M., Croy, I., Weidner, K., Kirschbaum, C., & Steudte‐Schmiedgen, S. (2021) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2021.105326 · Cited by 11
Langhammer, T., Hilbert, K., Praxl, B., Kirschbaum, C., Ertle, A., Asbrand, J., & Lueken, U. (2021) · Mental Health & Prevention · doi:10.1016/j.mhp.2021.200221 · Cited by 12
Differences in hair cortisol to cortisone ratio between depressed and non-depressed adolescent women
Zerroug, Y., Marin, M., Porter-Vignola, É., Garel, P., & Herba, C. M. (2025) · Stress · doi:10.1080/10253890.2025.2459726 · Cited by 11
“A study in adolescents demonstrated a link between adversity and childhood trauma in relation to hyperactivity of the HPA axis (Khoury et al., 2019).”
Blecker, M. K., Klusmann, H., Engel, S., Haering, S., Meyer, C., Skoluda, N., Nater, U. M., Knaevelsrud, C., & Schumacher, S. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.119914 · Cited by 11
Sociodemographics and chronic stress in mother–toddler dyads living in poverty
Bates, R. A., Ford, J. L., Jiang, H., Pickler, R. H., Justice, L. M., Dynia, J. M., & Ssekayombya, P. S. (2021) · Developmental Psychobiology · doi:10.1002/dev.22179 · Cited by 12
Lifetime exposure to violence and other life stressors and hair cortisol concentration in women
Lynch, R., Aspelund, T., Kormáksson, M., Flores‐Torres, M. H., Hauksdóttir, A., Arnberg, F. K., Lajous, M., Kirschbaum, C., & Valdimarsdóttir, U. A. (2021) · Stress · doi:10.1080/10253890.2021.2011204 · Cited by 13
“Indeed, four studies were underpinning the negative effects on HCC in this meta-analysis (Khoury et al., 2019), while 16 other studies on childhood maltreatment showed null or trend toward a positive association.”
InfluentialMaternal Sociodemographic Factors and Antenatal Stress
Andhavarapu, M., Orwa, J., Temmerman, M., & Musana, J. W. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18136812 · Cited by 11
“A meta-analysis published in 2019 [53] assessed the strength and direction (increase or decrease) of association between adverse life events such as maltreatment, natural disasters, accidents, domestic violence, etc.”
BackgroundGil, S. M., Cabaco, A. S., Moral-Martínez, J. D., Seisdedos-Benito, A., & Lundberg, U. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182010819 · Cited by 9
“Situations of stress, such as those triggered by IPV, are biologically regulated by the hypothalamic–pituitary–adrenal axis (HPA) [5,6] where the hypothalamus activates in the pituitary gland the release of hormones, such as adenocorticotropin (ACTH), in the blood.”
BackgroundInfluentialTan, H., Zhou, H., Chen, J., Ren, H., Guo, Y., & Jiang, X. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1341266 · Cited by 11
Bergunde, L., Karl, M., Borrmeister, M., Jaramillo, I., Weise, V., Mack, J. T., Weidner, K., Gao, W., Steudte‐Schmiedgen, S., & Garthus‐Niegel, S. (2024) · European Journal of Psychotraumatology · doi:10.1080/20008066.2024.2317674 · Cited by 9
“This highlights the need to account for moderating variables (e.g. type and timing of adversity, clinical status) in determining the pattern of cortisol alterations following adversity (Khoury et al., 2019).”
BackgroundInfluentialMeta-analysis of associations between childhood adversity and diurnal cortisol regulation
Perrone, L., Thorpe, D., Panahi, G. S., Kitagawa, Y., Lindhiem, O. J., & Bernard, K. (2023) · Development and Psychopathology · doi:10.1017/s0954579423000561 · Cited by 11
Senehi, N., Flykt, M. S., Biringen, Z. C., Laudenslager, M. L., Watamura, S. E., Garrett, B. A., Kominsky, T. K., Wurster, H. E., & Sarche, M. C. (2021) · Prevention Science · doi:10.1007/s11121-021-01307-7 · Cited by 15
“Additionally, both elevated and dampened HCC levels may be associated with experiences of adversity (Khoury et al., 2019); however, age-related variations are thought to partly explain these findings.”
Maier, B. C. L., Zillich, L., Streit, F., Wildenberg, K., Rietschel, M., Hammes, H., Witt, S. H., & Deuschle, M. (2022) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2022.105717 · Cited by 9
Relationship between hair cortisol concentrations and cognitive functioning in adolescents with ADHD
Llorens, M., Barba, M., Torralbas-Ortega, J., Nadal, R., Armario, A., Gagliano, H., Urraca, L., Pujol, S., Montalvo, I., Gracia, R., et al. (2023) · European Journal of Psychotraumatology · doi:10.1080/20008066.2023.2281752 · Cited by 8
“Finally, an interesting meta-analysis con fi rmed that childhood adversity is associated with both higher and lower HCCs (Khoury et al., 2019).”
BackgroundBates, R. A., & Dynia, J. M. (2023) · Psychology in the Schools · doi:10.1002/pits.23118 · Cited by 15
DHEA : a neglected biological signal that may affect fetal and child development
Bailey, N. A., Davis, E. P., Sandman, C. A., & Glynn, L. M. (2024) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13952 · Cited by 8
Torrecilla, P., & Neus Barrantes-vidal, A. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.746155 · Cited by 9
Castro-Vale, I., van Rossum, E. F. C., Staufenbiel, S. M., Severo, M., Mota‐Cardoso, R., & Carvalho, D. M. (2020) · Psychiatry Investigation · doi:10.30773/pi.2020.0212 · Cited by 9
Xiang, L., Zeng, X., Luo, Y., Tan, S., Wang, F., & Mao, X. (2023) · The International Journal of Psychiatry in Medicine · doi:10.1177/00912174231178108 · Cited by 10
“20 However, the psychological state measured by the psychological scale generally re fl ects throughout the psychological state (such as a month), and the time re fl ected on saliva, serum, or urine cortisol levels are inconsistent.”
BackgroundChampagne, F. A., Courtney, K., Bellatin, A., Miller, M., & Widom, C. S. (2025) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2025.107561 · Cited by 8
“…key variables at multiple timepoints across the lifespan that permits a more nuanced understanding of age/timing related variables and their association with childhood maltreatment and HCC. p r Given evidence that the type of maltreatment differentially predicts HCC (Khoury et al., 2019), we…”
Is economic hardship associated with young children's cortisol levels?
Santaularia, N. J., Kunin‐Batson, A., Sherwood, N. E., Gunnar, M. R., French, S. A., & Mason, S. M. (2023) · Developmental Psychobiology · doi:10.1002/dev.22390 · Cited by 7
“…cross-sectionally, few studies have examined the association between economic hardship and hair cortisol (Bhopal et al., 2019; Ertekin et al., 2021; Khoury et al., 2019; Ling et al., 2019; Palmer-Bacon et al., 2020; Tarullo et al., 2020; Vaghri et al., 2013; Vliegenthart et al., 2016), and even…”
BackgroundYirmiya, K., Motsan, S., Zagoory‐Sharon, O., Schonblum, A., Koren, L., & Feldman, R. (2022) · Psychological Medicine · doi:10.1017/s0033291722001350 · Cited by 8
“, 2016), other studies described HPA-axis hypo-activity in the aftermath of trauma, highlighting the need to consider potential moderators in the interpretation of the findings, such as type of stressor, timing effects, or individual and contextual determinants (Khoury et al., 2019; Steudte-Schmiedgen, Kirschbaum, Ale…”
BackgroundInfluentialChanges in Stress Following Wage Increases for Early Childhood Educators
Bates, R. A., & Dynia, J. M. (2024) · Early Childhood Education Journal · doi:10.1007/s10643-024-01666-0 · Cited by 7
“For example, while one may perceive the absence of stress, physiological biomarkers may be high; similarly, one may perceive intense stress, but physiological biomarkers may be high or even low (Ford et al., 2019; Khoury et al., 2019).”
Current and Cumulative Stress Experiences: A Model for Arab American Young Adults
Albdour, M. M., Templin, T., Zilioli, S., Hong, J. S., & Lumley, M. A. (2022) · Journal of the American Psychiatric Nurses Association · doi:10.1177/10783903221110235 · Cited by 7
“…HPA axis can disrupt this typical response by leading to hyperreactivity, where cortisol remains high over a prolonged period, or hyporeactivity, where the cortisol response is blunted and does not increase to the optimal level (De Kloet et al., 2005; Frodl & O’Keane, 2013; Khoury et al., 2019).”
BackgroundAdverse childhood experiences screening in healthcare settings: A focus on pediatric primary care
Negriff, S. L., Sidell, M. A., & DiGangi, M. J. (2024) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2024.106709 · Cited by 6
Impact of adverse childhood experiences on analgesia-related outcomes: a systematic review
Senaratne, D. N. S., Koponen, M. E., Barnett, K. N., Smith, B. H., Hales, T. G., Marryat, L., & Colvin, L. (2024) · British Journal of Anaesthesia · doi:10.1016/j.bja.2024.09.015 · Cited by 6
“133 It is of note that one included study used an objective measure of pain sensation (quantitative sensory testing) but did not find an association between ACEs and pain thresholds in various sensory modalities.”
Metadata
- Authors
- Khoury, J. E., Bosquet Enlow, M., Plamondon, A., & Lyons-Ruth, K.
- Affiliations
- Harvard University (US)
- University of Toronto (CA)
- Corresponding author
- Khoury, Jennifer E.
- ORCID
- Khoury, Jennifer E.
- Venue
- Psychoneuroendocrinology
- Publisher
- Elsevier BV
- Published
- 2019-05
- Volume
- 103
- Pages
- 104-117
- ISSN
- 0306-4530 (ISSN-L)
- PMC
- PMC6450779
- OpenAlex
- W2910167098
- Cited by
- 170
- References
- 106
- Citations by year
- 2026: 15 · 2025: 19 · 2024: 20 · 2023: 26 · 2022: 27 · 2021: 35 · 2020: 23 · 2019: 4
- FWCI
- 2.58
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychoneuroendocrinology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD079484)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- adversity, life events, hair cortisol, HPA axis dysregulation, hypothalamic-pituitary-adrenal axis, chronic stress, cortisol biomarkers
- MeSH terms
- Adverse Childhood Experiences, Female, Hair, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Male, Pituitary-Adrenal System, Stress, Psychological
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